NURS 354: GERONTOLOGICAL
NURSING QUIZ 1 QUESTIONS AND
ANSWERS
1. A 78-year-old patient is admitted with a new prescription for a lipophilic medication.
Which physiological change of aging most significantly affects the distribution of this drug?
A. Decreased total body water
B. Reduced serum albumin levels
C. Increased ratio of adipose tissue to lean muscle mass
D. Increased hepatic first-pass metabolism
Answer: C
Conceptual Explanation: In older adults, the proportion of body fat increases while lean
muscle mass decreases. Lipophilic (fat-soluble) drugs have a larger volume of distribution,
leading to a prolonged half-life and potential toxicity.
2. Which assessment finding is considered an abnormal sign of aging rather than a typical
age-related physiological change?
A. A systolic murmur heard at the base of the heart
B. Loss of high-frequency hearing (presbycusis)
,C. Decreased night vision and increased sensitivity to glare
D. Consistent urinary incontinence during coughing
Answer: D
Conceptual Explanation: Urinary incontinence is never a normal part of aging; it always
indicates a pathological process or functional impairment that requires investigation.
3. When applying the Stochastic Theory of Aging, which mechanism is primarily responsible
for cellular damage?
A. Random occurrences of environmental insults causing molecular damage
B. The influence of the neuroendocrine pacemaker
C. Genetically programmed cell death (apoptosis)
D. The Hayflick limit of cellular replication
Answer: A
Conceptual Explanation: Stochastic theories suggest that aging results from random
accumulation of damage over time (e.g., free radicals, cross-linking), whereas non-
stochastic theories view aging as a programmed process.
4. An 82-year-old patient exhibits sudden onset of confusion, visual hallucinations, and a
fluctuating level of consciousness. What is the priority nursing intervention?
A. Administer a PRN dose of haloperidol for agitation
B. Initiate a formal assessment for Alzheimer’s disease
, C. Assess for underlying physiological triggers such as hypoxia or UTI
D. Place the patient in soft wrist restraints to prevent falls
Answer: C
Conceptual Explanation: The symptoms describe delirium, which is an acute medical
emergency. The priority is to identify and treat the underlying cause (e.g., infection,
metabolic imbalance).
5. According to the Beers Criteria, which medication should be avoided in older adults due to
the high risk of anticholinergic side effects and orthostatic hypotension?
A. Warfarin
B. Lisinopril
C. Metformin
D. Amitriptyline
Answer: D
Conceptual Explanation: Amitriptyline is a tricyclic antidepressant with strong
anticholinergic properties, increasing risks of confusion, constipation, and falls in older
adults.
6. Which statement by a student nurse regarding the ‘Free Radical Theory’ indicates a need
for further teaching?
A. Free radicals are highly reactive molecules containing an extra electrical charge.
NURSING QUIZ 1 QUESTIONS AND
ANSWERS
1. A 78-year-old patient is admitted with a new prescription for a lipophilic medication.
Which physiological change of aging most significantly affects the distribution of this drug?
A. Decreased total body water
B. Reduced serum albumin levels
C. Increased ratio of adipose tissue to lean muscle mass
D. Increased hepatic first-pass metabolism
Answer: C
Conceptual Explanation: In older adults, the proportion of body fat increases while lean
muscle mass decreases. Lipophilic (fat-soluble) drugs have a larger volume of distribution,
leading to a prolonged half-life and potential toxicity.
2. Which assessment finding is considered an abnormal sign of aging rather than a typical
age-related physiological change?
A. A systolic murmur heard at the base of the heart
B. Loss of high-frequency hearing (presbycusis)
,C. Decreased night vision and increased sensitivity to glare
D. Consistent urinary incontinence during coughing
Answer: D
Conceptual Explanation: Urinary incontinence is never a normal part of aging; it always
indicates a pathological process or functional impairment that requires investigation.
3. When applying the Stochastic Theory of Aging, which mechanism is primarily responsible
for cellular damage?
A. Random occurrences of environmental insults causing molecular damage
B. The influence of the neuroendocrine pacemaker
C. Genetically programmed cell death (apoptosis)
D. The Hayflick limit of cellular replication
Answer: A
Conceptual Explanation: Stochastic theories suggest that aging results from random
accumulation of damage over time (e.g., free radicals, cross-linking), whereas non-
stochastic theories view aging as a programmed process.
4. An 82-year-old patient exhibits sudden onset of confusion, visual hallucinations, and a
fluctuating level of consciousness. What is the priority nursing intervention?
A. Administer a PRN dose of haloperidol for agitation
B. Initiate a formal assessment for Alzheimer’s disease
, C. Assess for underlying physiological triggers such as hypoxia or UTI
D. Place the patient in soft wrist restraints to prevent falls
Answer: C
Conceptual Explanation: The symptoms describe delirium, which is an acute medical
emergency. The priority is to identify and treat the underlying cause (e.g., infection,
metabolic imbalance).
5. According to the Beers Criteria, which medication should be avoided in older adults due to
the high risk of anticholinergic side effects and orthostatic hypotension?
A. Warfarin
B. Lisinopril
C. Metformin
D. Amitriptyline
Answer: D
Conceptual Explanation: Amitriptyline is a tricyclic antidepressant with strong
anticholinergic properties, increasing risks of confusion, constipation, and falls in older
adults.
6. Which statement by a student nurse regarding the ‘Free Radical Theory’ indicates a need
for further teaching?
A. Free radicals are highly reactive molecules containing an extra electrical charge.